Development and validation of the unifying elective orthopaedic score (UnEOS). A pilot study

Patient reported outcome measures (PROMs) are increasingly valued in orthopaedics. There are already many site specific or pathology specific scores. These scores are usually validated for specific pathologies and can be complicated and time consuming to use. The aim of the present pilot study is to develop a new orthopaedic score for elective operations, which measures patient satisfaction simply and quickly, and is not limited to a single site or pathology.

The UnEOS questionnaire has 16 questions. Eleven questions relate to the three main dimensions (Symptoms, Function, Mental Status) and can be used both preoperatively and postoperatively. Five questions are added to the questionnaire at the postoperative mode, which form the satisfaction dimension. For this pilot study we enrolled all patients listed for surgery from our foot and ankle clinics. Each patient was asked to complete the UnEOS and FADI questionnaires.

A total of 181 questionnaires were collected from patients (aged 56.4 ± 14.8, range 20-85) with a variety of foot and ankle pathologies. Scores were obtained both pre- and post-operatively. The scale reliability was checked with the Cronbach's Alpha score, which was 0.87 for the UnEOS scale. Each subscale had good reliability with 0.73, 0.77 and 0.76 respectively (Symptoms, Function, Mental Status). The validity of the scale was checked using the Spearman's Rho correlation, which was strong between the UnEOS and the FADI score (0.79) and each subscale (0.7, 0.75 and 0.69 respectively).

The UnEOS score is a valid and easy to use PROM which is not limited by site or pathology. Further validation with other orthopaedic pathologies will lead to a Unified Elective Orthopaedic score.